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[null,"Brampton Canadettes Girls Hockey Association"]
[null,"340 Vodden Street East, Brampton, ON L6V 2N2 • 905-874-1788"]
[]
["REGISTRATION REFUND REQUEST FORM 2021-2022"]
[]
["PLAYER NAME:",null,null,null,null,null,"DATE:"]
[]
["DIVISION CATEGORY"]
["     HL - House League",null,null,null,"     REP - Representative, choose option below"]
["     DS - Development Stream",null,null,null,null,"     AA","     A","     BB","     B"]
["DIVISION LEVEL"]
["      Rising Stars",null,null,"      U11 (Atom)",null,null,"      U18 (Midget)"]
["      U7 (Tyke)",null,null,"      U13 (Peewee)",null,null,"      U22 (Intermediate)"]
["      U9 (Novice)",null,null,"      U15 (Bantam)",null,null,"      Senior"]
[]
["PARENT INFORMATION"]
[null,"Parent Name:"]
[null,"Street Address:"]
[null,"City/Postal Code:"]
[null,"Email:"]
[null,"Phone Number:",null,null,null,"Cell Number:"]
[]
["REASON FOR REFUND"]
["     Medical",null,null,"     Moved",null,null,"     Other"]
["Please explain reason below:"]
[]
[]
[]
[]
["PAYMENT INFORMATION"]
["Paid Via:","     Visa","     MasterCard",null,"     Cheque / CHQ #:",null,null,null,"     Cash"]
["Name on Credit Card:"]
["Date Paid:",null,null,null,"Registration Amount Paid:",null,null,0]
[]
["CALCULATION OF REFUND - BCGHA OFFICE USE ONLY"]
[null,null,null,"Registration Payment Received:",0]
[null,null,"LESS:","Uniforms"]
[null,null,null,"Ice Times"]
[null,null,null,"Rep Fees"]
[null,null,null,"Administation Fee",50]
[null,null,null,"OWHA Player Fee",55]
[null,null,null,"Other"]
[null,null,null,"AMOUNT OF REFUND:",{"$f":"E36-SUM(E37:E42)","v":-105}]
[]
["REFUND APPROVAL - BCGHA OFFICE USE ONLY"]
["Verified: If fees paid by team, did player pay FULL amount to REP Team?",null,null,null,null,null,null,"     Yes","     No"]
[null,null,"Refund Approved By:"]
[null,null,"Refund Paid Via Cheque #:",null,null,null,"Date of Cheque:"]